New research from the MooDFOOD team: High sugar intake linked with poorer long-term mental health

Post date: 28 Jul 2017

Men with high sugar intakes have an increased likelihood of common mental disorders
(such as anxiety and depression) after 5 years compared to those with low
intakes, according to UCL research. The study also showed that having
a mood disorder did not make people more inclined to eat foods with a
high sugar content.

The report, published today in Scientific Reports used data from
the Whitehall II cohort and analysed the sugar intake from sweet food and beverages and occurrence
of common mental disorders in over 5000 men and over 2000 women for a
period of 22 years between 1983 and 2013.

Although previous studies have found an
increased risk of depression with higher consumption of added sugars, none
examined the role of ‘reverse causation’. If people with anxiety and/or
depression tended to consume more sugary foods and
drinks, this could be the real reason why a link
between sugar intake and poorer mental health is observed. Although the study looked for this link, it was not
seen in the data: men and women with
mental disorders were not more likely to consume more sugar. As
a result, the evidence that mental health is
adversely affected by a high sugar intake is strengthened.

The study
categorised daily sugar intake (in grams) from sweet food and
beverages into three similar sized groups. Men in the top third, who
consumed more than 67g, had a 23% increased chance of incident common
mental disorders after five years, (independent of health behaviours,
socio-demographic and diet-related factors, adiposity and other
diseases) compared to those in the bottom third, who consumed
less than 39.5 g. According to the National Diet and Nutrition
Survey published in 2013 men in the UK consume an
average 68.4 grams of added sugar per day (75 per cent from sweet
foods and beverages).

Men and women with mood disorders and
high sugar consumption also had an increased chance of being
depressed again after 5 years compared to those with lower intakes, but this
finding was not independent of other socio-demographic, health and
diet-related factors.

Anika Knüppel (UCL Institute
of Epidemiology and Public Health), lead author of the paper
said: “High sugar diets have a number of influences on our health but our
study shows that there might also be a link between sugar and mood disorders,
particularly among men. There are numerous factors that
influence chances for mood disorders, but having a diet high in
sugary foods and drinks might be the straw that breaks the
camel's back. The study found no link between sugar intake
and new mood disorders in women and it is unclear why.
More research is needed to test the sugar-depression effect in large
population samples.

Anika Knüppel (UCL Institute
of Epidemiology and Public Health), lead author of the paper
said: “High sugar diets have a number of influences on our health but our
study shows that there might also be a link between sugar and mood disorders,
particularly among men. There are numerous factors that
influence chances for mood disorders, but having a diet high in
sugary foods and drinks might be the straw that breaks the
camel's back. The study found no link between sugar intake
and new mood disorders in women and it is unclear why.
More research is needed to test the sugar-depression effect in large
population samples.

Anika Knüppel (UCL Institute
of Epidemiology and Public Health), lead author of the paper
said: “High sugar diets have a number of influences on our health but our
study shows that there might also be a link between sugar and mood disorders,
particularly among men. There are numerous factors that
influence chances for mood disorders, but having a diet high in
sugary foods and drinks might be the straw that breaks the
camel's back. The study found no link between sugar intake
and new mood disorders in women and it is unclear why.
More research is needed to test the sugar-depression effect in large
population samples.

Anika Knüppel (UCL Institute
of Epidemiology and Public Health), lead author of the paper
said: “High sugar diets have a number of influences on our health but our
study shows that there might also be a link between sugar and mood disorders,
particularly among men. There are numerous factors that
influence chances for mood disorders, but having a diet high in
sugary foods and drinks might be the straw that breaks the
camel's back. The study found no link between sugar intake
and new mood disorders in women and it is unclear why.
More research is needed to test the sugar-depression effect in large
population samples.

MooDFOOD at ISNPR

Post date: 11 Jul 2017

MooDFOOD is delighted to be presenting the project at the first International Society of Nutritional Psychiatry Research this summer.

This meeting will reflect the broad spectrum of research, from the sub-cellular to translation and implementation science and will cater to multidisciplinary interests. Researchers and clinicians from the fields of public health, diabetes, cardiovascular disease, obesity and dietetics, as well as psychiatry and psychology will participate. There will also be a strong focus on basic science and the biological processes and factors that underpin the links between diet, nutrition and mental health, including the brain-gut-microbe axis, immunology and metabolic processes and molecular science.
An important aspect of the ISNPR conference will be workshops which will offer training from skilled and highly experienced psychiatrists and dietitians. These workshops will focus on the practical aspects of nutrition and clinical care for those with mental disorders. Learn more about ISNPR and the meetings on the
conference website

MooDFOOD at ISNPR

Post date: 30 Jun 2017

Professor Marjolein Visser is a nutritionist and epidemiologist and professor of Healthy Ageing with specific attention to nutrition and clinical dietetics at the Department of Health Sciences of the VU University in Amsterdam, as well as the Department of Internal Medicine, VU Medical Center. Her research interests are nutritional and other lifestyle determinants of healthy ageing. Important research areas are malnutrition, obesity, sarcopenia and depression. She is involved in (inter)national ageing studies and lifestyle intervention studies and is a member of the Health Council of the Netherlands.

Professor Visser is the coordinator of three large EU consortia: MooDFOOD, focusing on the role of nutrition in the prevention of depression, PROMISS, focusing on the prevention of malnutrition in older adults, and the JPI MaNuEL, a HDHL Knowledge Hub focusing on malnutrition in older adults. She has authored over 230 scientific publications (H-index 70) and serves on the editorial boards of several international scientific journals.

She has been invited to present MooDFOOD in August 2017 in Washington DC at International Society for Nutritional Psychiatry Research

Professor Visser, congratulations on your upcoming plenary session at the first major international meeting of the International Society for Nutritional Psychiatry Research, outside of Washington, DC, this August. ISNPR is a relatively new organisation in this emerging field, is that right?

During recent years, there has been increasing attention to investigating the link between nutrition and mental diseases. Our MooDFOOD project, which started about 3 years ago, is a unique contributor to this new research field. The recent establishment of a society focusing specifically on the relationship between nutrition and psychiatric disorder will help to give this research field the attention it deserves. Furthermore, it will enable researchers to meet at its first meeting and share their research findings and ideas. I am looking forward to this meeting and would like to stimulate those working in this field and those who are interested in the role of nutrition in psychiatric diseases to attend.

This seems like a uniquely multi-disciplinary conference. Please tell us what you have planned for the session, particularly around recent developments in the MooDFOOD project:

During my lecture I will first introduce the MooDFOOD project to the audience. We are really proud of this important project and its team, and the results of this project will certainly contribute to the field. Of course I will also present some results of the project. These will be the results of our observational research as the intervention studies conducted within the MooDFOOD project are still running and results cannot be expected until 2018. I will present the results of a unique harmonized meta-analysis that we are conducting in collaboration with 6 cohort studies and which is coordinated by dr. Mary Nicolaou. In each of these cohorts, a local investigator has investigated the association between three dietary indices and depression using a standardized protocol. We used the MDS (Mediterranean Diet Score), AHEI-2010 (Alternative Healthy Eating Index) and DASH (Dietary Approaches to Stop Hypertension) indices, which all differ slightly in the healthy and unhealthy food products and nutrients they include in their score. These scores generally indicate how ‘healthy’ the diet of a person is. In a next step, the results of these local analyses are combined in a meta-analysis. This will give us important evidence on whether dietary patterns are linked to depression, whether this is consistent across cohorts (that differ in age, country and other characteristics), and which of these dietary patterns is most strongly associated with depression.

Has the MooDFOOD team presented at other interesting conferences recently?

On May 18th, 2017, the MooDFOOD team organized a symposium during ECO2017, the 24th European Congress on Obesity, held in Porto, Portugal. Since obesity is linked to both diet and depression, and thus is an important factor in all the research that we perform within the MooDFOOD project, we feel that our project is very relevant for the obesity research community. Laura Winkens presented the Mindful Eating Behaviour Scale that she developed within the MooDFOOD project and showed its association with the body mass index. Nadine Paans talked about weight gain in depressed persons and which biopsychosocial variables contribute to this weight gain. Deborah Gibson-Smith presented her work on the association between obesity and depressive symptoms and whether this association differs between different ethnic groups. And finally, Anika Knüppel talked about the bidirectional association of body weight and waist circumference with change in common mental disorder. The symposium was very well attended and even attracted some media attention.

Project MooDFOOD: Meet Esther Vermeulen

Post date: 14 Jun 2017

Esther, please describe the project and your role in it

MooDFOOD is a multidisciplinary consortium involving 13 organisations in 9 European countries, using a unique integrative approach which combines expertise in nutrition, consumer behaviour, psychiatry and preventive psychology. By integrating epidemiological evidence and performing a multi‐centre prevention trial, we employ a unique approach to unraveling the multifaceted links between food intake, nutrient status, food‐related behaviour and obesity with depression.

In turn, this evidence will be used to develop guidelines and practical tools. In collaboration with a diverse group of experts and other stakeholders, this resource will be used to provide policy guidance at both the EU- and Member State level. The main goal of MooDFOOD is to deliver sustainable, evidence‐based nutritional strategies for the effective prevention of depression among EU citizens.

My role is to deliver observational evidence for the relationship between food consumption patterns and depression. This information was among several elements used for the development of dietary advice given to people participating in the MooDFOOD trial. Furthermore, my role is to disseminate the obtained knowledge about this topic to other experts, by giving presentations at congresses, and by collaborating with other MooDFOOD partners in Europe.

Please describe your paper and its relevance to the project.

In my paper I investigated the association between a healthy dietary pattern and depressive symptoms over time among older adults in Tuscany, Italy. We observed that a dietary pattern, typical for the Tuscan population, which is high in vegetables, olive oil, fish, fruit, cereals, eggs, potatoes and moderate intakes of wine, red and processed meat consistently lowers depressive symptoms over a 9-year period. In other words, not only the typically known ‘healthy foods’ like olive oil, fish and vegetables, but also intakes of food generally considered ‘less healthy’ such as red and processed meat, are important and are part and parcel of a dietary pattern associated with lower depressive symptoms. The most important implication for practice is that diet could be used as a plausible tool to test in practice to lower depressive symptoms.

EU Project MooDFOOD- new nutritional science research on sugar and mental health from Anika Knüppel

Post date: 30 May 2017

According to the WHO, mental disorders are one of the top public health challenges in the European region. While nutrition has been shown to be a key factor in physical health the MoodFOOD project addresses the role of nutrition in mental health. The first Work Package of the MoodFOOD project aims to investigate the bidirectional association of diet and obesity with depression using observational evidence. The goal here is to identify any food patterns, groups and/or nutrients that could have the potential to reduce or increase the risk of depression. The project also recognises that depression, or depressed mood, may change or influence food consumption and takes this into account in research.

From London, Anika is working with observational data from the Whitehall II study, which is a cohort of over 10.000 British Civil Servants who have been completing questionnaires and taking part in health screenings over the last 30 years (find out more on: http://www.ucl.ac.uk/whitehallII/about-us). This rich dataset permits Anika and her colleagues to view the sequence of health events and health behaviours.

The UCL team, led by Anika Knüppel, have a paper under review reporting on the associations between sugar intake from sweet food and drinks with common mental disorders and depression. The analysis is based on 22 years of follow up and 7 waves of data from the Whitehall II study.

The analyses suggest an adverse effect of the consumption of sweet foods and beverages on long-term psychological health, with higher consumption linked with greater odds of depression 5 years later.
Poor mental health was not associated with high sweet food and drink intake 5 years later. That there was no effect of depression on later sweet food and drink intake, means that ‘reverse causation’ is not likely to account for the association. It appears that the link observed is due to the effect of diet on mental health, rather than the other way around.

In conjunction with other research, these findings indicate lower sugar intake might not only be favourable for physical health but also mental health. In the light of public health initiatives on sugar intake, Anika’s results lend added support for interventions that aim to reduce sugar intake on a population level.

Further details of the study will become available when the research is accepted for publication.

Anika Knüppel is a PhD student in Epidemiology and Public Health at University College London (UCL) in the UK. She is working on findings for the first Work Package of the European MoodFOOD project. Anika holds a BSc and MSc in Nutritional Sciences from Martin Luther University Halle-Wittenberg in Germany and has had additional training in nutritional epidemiology.